Signs and Symptoms of Tobacco Withdrawal

Hughes, John R.

doi:10.1001/archpsyc.1986.01800030107013

Cited by 1,669Smoking Behavior and CessationSubstance Abuse Treatment and OutcomesPrenatal Substance Exposure Effects

Signs and Symptoms of Tobacco Withdrawal

Hughes, John R.·1986·Archives of General Psychiatry

DOI 10.1001/archpsyc.1986.01800030107013

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Abstract

To test the validity, magnitude, and clinical significance of the signs and symptoms of tobacco withdrawal defined by DSM-III, both observed and reported signs and symptoms were measured in 50 smokers during two days of ad lib smoking and then during the first four days of abstinence. Observer and subject ratings of the DSM-III symptoms of craving for tobacco, irritability, anxiety, difficulty concentrating, and restlessness increased after cessation. In addition, bradycardia, impatience, somatic complaints, insomnia, increased hunger, and increased eating occurred after cessation. The frequency and intensity of these symptoms varied across subjects; however, the average distress from tobacco withdrawal was similar to that observed in psychiatric outpatients. Subjects who had more withdrawal discomfort were more tolerant to the cardiovascular effects of nicotine. Subjects who had more withdrawal discomfort did not have a lower rate of smoking cessation.

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Different types of withdrawal syndromes described with SSRIs and other CNS drug classes include new withdrawal symptoms, rebound, and persistent postwithdrawal disorders.
“Different types of syndromes have been described with the withdrawal from SSRIs and other CNS drug classes, including benzodiazepines, antipsychotics, antidepressants, opiates, barbiturates, and alcohol: (1) new withdrawal symptoms (classic withdrawal symptoms from CNS drugs) [1,[4][5][6][9][10][11][12] , (2) rebound [2,6,9,[13][14][15][16] , and (3) persistent postwithdrawal disorders [7,17,18] (”
From New Classification of Selective Serotonin Reuptake Inhibitor Withdrawal (2015) · cites this paper as [17]
Persistent postwithdrawal disorders or tardive receptor supersensitivity disorders have been described with the use of antipsychotic medication.
“Persistent postwithdrawal disorders or tardive receptor supersensitivity disorders have been described with the use of antipsychotic medication [7,17,18] .”
From New Classification of Selective Serotonin Reuptake Inhibitor Withdrawal (2015) · cites this paper as [17]
Tardive dyskinesia and supersensitivity psychosis are well-known postwithdrawal disorders (also called supersensitivity syndromes).
“Tardive dyskinesia and supersensitivity psychosis are well-known postwithdrawal disorders (also called supersensitivity syndromes) [7,17,18] .”
From New Classification of Selective Serotonin Reuptake Inhibitor Withdrawal (2015) · cites this paper as [17]

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Authors: Hughes, J. R.
Affiliations: University of Vermont (US)
Corresponding author: Hughes, John R.
ORCID: Hughes, John R.
Venue: Archives of General Psychiatry
Publisher: American Medical Association (AMA)
Published: 1986-03-01
Volume: 43
Issue: 3
Pages: 289
ISSN: 0003-990X (ISSN-L)
DOI: 10.1001/archpsyc.1986.01800030107013
OpenAlex: W2110569081
Cited by: 1,669
References: 22
Citations by year: 2026: 22 · 2025: 39 · 2024: 39 · 2023: 52 · 2022: 42 · 2021: 38 · 2020: 63 · 2019: 67 · 2018: 65 · 2017: 69 · 2016: 91 · 2015: 68 · 2014: 72 · 2013: 55 · 2012: 68
FWCI: 18.56
Type: journal article
Language: en
Open access: closed
Locations: Archives of General Psychiatry (publishedVersion)
PubMed (publishedVersion)
Funders: National Institute on Drug Abuse (DA-02988-01)
Topics: Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
Keywords: nicotine withdrawal, nicotine withdrawal symptoms, smoking cessation, nicotine tolerance, irritability, anxiety, craving, bradycardia, insomnia, dietary habits, observer ratings
MeSH terms: Adult, Mental Disorders, Chewing Gum, Female, Humans, Male, Manuals as Topic, Nicotine, Plants, Toxic, Psychiatric Status Rating Scales, Substance Withdrawal Syndrome, Nicotiana, Tobacco Use Disorder

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